Integumentary System Practice Questions

36 multiple-choice questions on Integumentary system for paramedic and EMT students, from Chapter 8 (Anatomy and Physiology). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

36 practice questions

1. The outermost layer of the skin is the:

   1. A. Dermis
   2. B. Epidermis
   3. C. Fascia
   4. D. Subcutaneous layer
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   Answer: B. Epidermis

   The epidermis is the outer layer and has no blood vessels. It is a waterproof barrier.

2. Which skin layer contains blood vessels, nerves, sweat glands, and hair follicles?

   1. A. Dermis
   2. B. Epidermis
   3. C. Fascia
   4. D. Stratum corneum
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   Answer: A. Dermis

   The dermis holds the working structures of the skin. A burn that reaches it is at least partial thickness.

3. The subcutaneous layer is composed mainly of:

   1. A. Adipose (fat) tissue
   2. B. Stratified epithelial cells
   3. C. Smooth muscle bundles
   4. D. Hair follicles and glands
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   Answer: A. Adipose (fat) tissue

   Subcutaneous fat insulates, cushions, and stores energy.

4. Sebaceous glands secrete:

   1. A. Keratin protein
   2. B. Watery sweat
   3. C. Sebum (oil)
   4. D. Melanin pigment
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   Answer: C. Sebum (oil)

   Sebum keeps skin and hair soft and waterproof.

5. How does the skin release excess body heat?

   1. A. Vasoconstriction and shivering
   2. B. Piloerection and vasoconstriction
   3. C. Increased melanin production
   4. D. Vasodilation and sweating
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   Answer: D. Vasodilation and sweating

   Dilated skin vessels radiate heat, and sweat removes heat as it evaporates.

6. All of the following are functions of the skin EXCEPT:

   1. A. Temperature regulation
   2. B. Protection from infection
   3. C. Sensation
   4. D. Producing red blood cells
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   Answer: D. Producing red blood cells

   Red blood cells come from red bone marrow. The skin also helps make vitamin D.

7. The skin's largest contribution to homeostasis is:

   1. A. Absorbing nutrients from the environment
   2. B. Producing red and white blood cells
   3. C. Serving as a barrier that limits fluid loss
   4. D. Secreting hormones that regulate metabolism
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   Answer: C. Serving as a barrier that limits fluid loss

   It is the body's first line of defense and also helps regulate temperature through sweating and blood flow.

8. The stratum corneum is:

   1. A. Fatty insulating layer beneath the dermis
   2. B. Deepest layer of dividing epidermal cells
   3. C. Vascular connective layer of the dermis
   4. D. Outer layer of dead, keratinized cells
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   Answer: D. Outer layer of dead, keratinized cells

   It provides waterproofing and protection.

9. The germinal layer of the epidermis is responsible for:

   1. A. Secreting sweat onto the skin surface
   2. B. Sensing touch and pressure stimuli
   3. C. Producing new cells that migrate outward
   4. D. Storing fat that insulates the body
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   Answer: C. Producing new cells that migrate outward

   The germinal (basal) layer continuously divides, and the new cells take weeks to migrate to the surface.

10. Keratin contributes to the skin by:

    1. A. Giving the skin its color and UV protection
    2. B. Producing oil that lubricates hair and skin
    3. C. Detecting pressure and light touch in the dermis
    4. D. Toughening and waterproofing the outer layer
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    Answer: D. Toughening and waterproofing the outer layer

    Hair and nails are also keratin.

11. Melanin functions to:

    1. A. Trap and kill bacteria on the skin surface
    2. B. Regulate body temperature through sweating
    3. C. Produce vitamin D from sunlight exposure
    4. D. Absorb UV radiation and give skin pigment
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    Answer: D. Absorb UV radiation and give skin pigment

    Melanin provides pigment and protects deeper cells against ultraviolet radiation. Melanocytes produce it in the epidermis.

12. Vitamin D production in the skin requires:

    1. A. Secretion from the sweat glands
    2. B. Exposure to cold temperatures
    3. C. Sebum from the sebaceous glands
    4. D. Ultraviolet light from sunlight
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    Answer: D. Ultraviolet light from sunlight

    Vitamin D supports calcium absorption.

13. Sweat glands contribute to homeostasis by:

    1. A. Insulating the body against heat loss
    2. B. Cooling the body through evaporation
    3. C. Absorbing water through the skin surface
    4. D. Lubricating the skin and hair with oil
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    Answer: B. Cooling the body through evaporation

    Evaporation of sweat cools the body, and sweat also excretes small amounts of waste. Sweat loss depletes water and electrolytes.

14. Hair follicles are located in the:

    1. A. Subcutaneous tissue only
    2. B. Dermis
    3. C. Fascia
    4. D. Epidermis
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    Answer: B. Dermis

    Sebaceous glands empty into them.

15. The arrector pili muscle causes:

    1. A. Skin to blanch from vasoconstriction
    2. B. Skin color to darken after sun exposure
    3. C. Sweat to be released onto the skin
    4. D. Hair to stand up, producing goose bumps
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    Answer: D. Hair to stand up, producing goose bumps

    It is a response to cold or fear.

16. Nerve endings in the skin detect:

    1. A. Pressure and vibration, but not pain
    2. B. Pain only, through free nerve endings
    3. C. Temperature only, through thermoreceptors
    4. D. Touch, pressure, temperature, and pain
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    Answer: D. Touch, pressure, temperature, and pain

    Density of receptors varies by region.

17. Skin color changes are clinically useful because they reflect:

    1. A. Inherited pigment only, not current status
    2. B. Ambient temperature and recent sun exposure
    3. C. Core body temperature and hydration only
    4. D. Perfusion, oxygenation, and systemic disease
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    Answer: D. Perfusion, oxygenation, and systemic disease

    Skin color reflects perfusion, oxygenation, and certain systemic conditions. Pallor, cyanosis, and jaundice each suggest different problems.

18. Cyanosis indicates:

    1. A. Excess oxygen bound to hemoglobin
    2. B. Elevated bilirubin from liver disease
    3. C. Inadequate oxygenation of hemoglobin
    4. D. Vasodilation from a systemic infection
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    Answer: C. Inadequate oxygenation of hemoglobin

    The bluish color reflects deoxygenated hemoglobin. It appears first in the mucous membranes and nail beds.

19. Jaundice suggests a problem involving the:

    1. A. Kidneys or impaired excretion of urea
    2. B. Liver or breakdown of red blood cells
    3. C. Heart or poor peripheral perfusion
    4. D. Lungs or inadequate oxygen exchange
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    Answer: B. Liver or breakdown of red blood cells

    Bilirubin accumulates in tissue.

20. Pallor most often reflects:

    1. A. Fever with increased metabolic rate
    2. B. Reduced skin perfusion or anemia
    3. C. Dilation of the skin's blood vessels
    4. D. Excess oxygen saturation of the blood
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    Answer: B. Reduced skin perfusion or anemia

    Pallor reflects reduced blood flow to the skin or anemia. It accompanies shock and blood loss.

21. Flushed skin most often reflects:

    1. A. Hypothermia with slowed metabolism
    2. B. Anemia from reduced red cell mass
    3. C. Vasodilation of skin blood vessels
    4. D. Vasoconstriction of skin blood vessels
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    Answer: C. Vasodilation of skin blood vessels

    Fever, heat exposure, and certain toxins dilate skin vessels. Carbon monoxide poisoning may also produce it.

22. Diaphoresis refers to:

    1. A. Profuse sweating
    2. B. Peeling of the skin
    3. C. Abnormally dry skin
    4. D. Redness of the skin
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    Answer: A. Profuse sweating

    It often accompanies sympathetic activation.

23. Skin turgor assesses:

    1. A. Hydration and elasticity
    2. B. Skin color and perfusion
    3. C. Core body temperature
    4. D. Light touch sensation
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    Answer: A. Hydration and elasticity

    It is less reliable in older adults.

24. Capillary refill is best assessed by:

    1. A. Pinching the skin and timing how fast it flattens
    2. B. Raising the limb and timing its color change
    3. C. Palpating the carotid pulse for strength
    4. D. Pressing a nail bed and timing color return
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    Answer: D. Pressing a nail bed and timing color return

    Normal is generally under 2 seconds. Press the nail bed until it blanches and time the return of color. Pinching skin and watching it flatten tests turgor and hydration, and timing color change after limb elevation is a vascular test, not capillary refill.

25. A burn that involves only the epidermis is classified as:

    1. A. Fourth degree
    2. B. Superficial
    3. C. Partial thickness
    4. D. Full thickness
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    Answer: B. Superficial

    It is red and painful without blisters.

26. A burn involving the epidermis and part of the dermis is:

    1. A. Full thickness, with charred leathery skin
    2. B. Subdermal, involving muscle and bone
    3. C. Superficial, with redness and no blisters
    4. D. Partial thickness, typically with blisters
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    Answer: D. Partial thickness, typically with blisters

    Nerve endings remain, so it is very painful.

27. A full-thickness burn destroys:

    1. A. Only the hair follicles and sweat glands
    2. B. The epidermis and upper part of the dermis
    3. C. The epidermis only, leaving the dermis
    4. D. The epidermis and the entire dermis
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    Answer: D. The epidermis and the entire dermis

    It may extend into deeper tissue. Nerve endings are destroyed, so the burn site itself is often painless.

28. Skin's role in preventing infection depends on:

    1. A. Hair that traps microbes before they reach skin
    2. B. An intact barrier, acidic pH, and normal flora
    3. C. Rich dermal blood flow that delivers antibodies
    4. D. Sweat that washes bacteria off the surface
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    Answer: B. An intact barrier, acidic pH, and normal flora

    The skin's acidic surface and normal flora also discourage pathogens. Any break in the skin is a portal for infection.

29. The subcutaneous layer is also called the:

    1. A. Stratum corneum
    2. B. Fascia
    3. C. Hypodermis
    4. D. Dermis
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    Answer: C. Hypodermis

    It connects the skin to underlying structures.

30. Fascia is best described as:

    1. A. A fibrous sheet enclosing muscles and organs
    2. B. A layer of fat beneath the dermis that insulates
    3. C. A gland that secretes lubricating fluid
    4. D. The deepest cellular layer of the epidermis
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    Answer: A. A fibrous sheet enclosing muscles and organs

    Fascia is fibrous connective tissue. Compartment syndrome involves pressure within fascial compartments.

31. Aging skin typically shows:

    1. A. A thicker layer of subcutaneous fat
    2. B. Greater elasticity from added collagen
    3. C. Thinner, less elastic skin that heals slowly
    4. D. Faster turnover of epidermal cells
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    Answer: C. Thinner, less elastic skin that heals slowly

    Aging skin thins, loses elasticity, and heals slowly. It bruises and tears easily.

32. Infants lose heat rapidly through the skin because they have:

    1. A. Large surface area relative to body mass
    2. B. An overactive shivering response to cold
    3. C. Fewer blood vessels near the skin surface
    4. D. A higher rate of sweating than adults
    Show answer

    Answer: A. Large surface area relative to body mass

    Infants also have thin skin and little insulating fat. Keep them covered, including the head.

33. Sebum protects the skin by:

    1. A. Carrying sensation from the hair follicle
    2. B. Cooling the skin through evaporation
    3. C. Lubricating and waterproofing skin and hair
    4. D. Absorbing ultraviolet light to prevent burns
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    Answer: C. Lubricating and waterproofing skin and hair

    Excess production contributes to acne.

34. Nails are composed of:

    1. A. Hardened cartilage cells
    2. B. Dense collagen fibers
    3. C. Keratinized cells
    4. D. Calcified bone tissue
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    Answer: C. Keratinized cells

    Nail bed color is useful for assessing perfusion.

35. Thermoregulation through the skin fails in older adults partly because of:

    1. A. A thicker layer of insulating fat
    2. B. Reduced sweating and poorer skin circulation
    3. C. A higher resting metabolic rate
    4. D. Increased sweating that cools excessively
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    Answer: B. Reduced sweating and poorer skin circulation

    Thinner skin also contributes. This raises both hypothermia and hyperthermia risk.

36. Which skin finding would most concern you in a patient with fever?

    1. A. Mottled, cool, clammy skin
    2. B. Flushed cheeks and warm hands
    3. C. Hot, dry skin with flushing
    4. D. Warm skin with normal turgor
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    Answer: A. Mottled, cool, clammy skin

    Mottled or cool, clammy skin suggests poor perfusion, so the patient may be in shock.